血清降钙素原与C反应蛋白在感染性疾病中的诊断应用(1)
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[摘要] 目的：探讨血清降钙素原(PCT)、C反应蛋白(CRP)在感染性疾病诊断中的应用价值。方法：采用全定量的电化学发光法测定58例细菌感染性疾病患者及42例非细菌感染性疾病患者的PCT，应用免疫散射比浊法测定患者的CRP，并同时检测患者白细胞总数及分类。结果：58例细菌感染性疾病患者血清PCT、CRP及WBC均显著升高(P<0.01)。PCT及WBC在两组间的阳性率比较差异具有统计学意义(P<0.01)，而CRP差异无统计学意义(P>0.05)。三者对细菌感染诊断的敏感性分别为93.1%、72.4%和63.8%；特异性分别为85.7%、59.5%、71.4%。对细菌感染的诊断PCT比CRP及WBC具有更高的敏感性及特异性(P<0.01)。结论：血清PCT检测优于血清CRP和WBC检测, 可用于感染性疾病细菌感染与病毒感染的鉴别诊断。
[关键词] 降钙素原；C反应蛋白；感染性疾病；细菌感染
[中图分类号] R446.1 [文献标识码] A [文章编号] 1674-4721(2012)01(b)-088-02
Determination of serum procalcitonin and creactive protein in infection diseases
ZHANG Wei, CHEN Chunguang
Department of Laboratory, Hospital for Infectious Diseases of Henan Province, Zhengzhou 450015, China
[Abstract] Objective: To evaluate the value of procalcitonin and CRP as prognostic markers in infections. Methods: PCT of 58 cases with bacterial infection and 42 cases with non-bacterial infection were determined by quantitative electrochemical luminescence with PCT, CRP was detected with immunonephelometry, simultaneously, classification of leukocytes were detected. Results: Serum PCT, CRP and WBC of 58 cases of patients with bacterial infections were significantly higher (P<0.01). PCT and WBC positive rate between the two groups had statistically significant difference (P<0.01), but CRP have not statistical significance (P>0.05). The sensitivity of the three diagnostic method were 93.1%, 72.4% and 63.8% respectively; specificity were 85.7%, 59.5%, 71.4% respectively. PCT had a higher sensitivity and specificity (P<0.01) in the diagnosis of bacterial infection than CRP and WBC. Conclusion: Serum PCT is better than CRP and WBC in the differentiation between bacterial infection and viral infection.
[Key words] Procalcitonin; C-reactive protein; Infectious diseases; Bacterial infection
感染性疾病是临床常见疾病，并且严重细菌感染、脓毒血症及随后发生的多器官功能衰竭是导致患者死亡的重要原因之一。其早期往往临床症状不典型，进展快[1-2]。因此， 早期诊断细菌感染、判断感染的严重程度并监测临床治疗效果对提高患者的生存率有重要意义。作为降钙素(calciton，CT) 的前体物，降钙素原(procalcitonin，PCT) 在健康人血清中水平极低，几乎不能检测到。但当存在细菌感染时，PCT 水平即明显升高，因此可以作为细菌感染性疾病的诊断和鉴别指标。CRP是急性时相蛋白的主要组成部分，是炎症反应的重要标志物[3]。为此，笔者分别进行了血清降钙素原(PCT)和C反应蛋白(CRP)的检测 ......
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